Orthotown January/February 2020 - 41
Final
Results
Fig. 2: After
was bonded, a NiTi open-coil spring was
placed, and an elastic thread was activated
from the UR2 to the spring. The thread
offers just enough activation to maintain
proper arch form and allow the spring to
express lateral forces.
Treatment progressed through the
archwire sequence (all NiTi wires) to
0.018, 0.014x0.025 and 0.018x0.025 to
gain the majority of the space required
through lateral expansion. Keep in mind
that the same spring and thread mechanics
were maintained throughout this sequence
with very light activation. The majority
of the space required to engage the UR2
was through posterior arch development,
not from the open-coil spring.
At about 12 months, we were able to
drop back to a 0.014 NiTi wire to engage
the UR2, progressing through the archwire
sequence once again (from 0.014 to 0.018
to 0.014x0.025) before finally moving into
the 0.019x0.025 fi nishing wire.
Interproximal reduction (IPR) was
performed U3-3 to reduce unwanted
black triangle spaces, common with severe
crowding and anterior crossbite cases.
Performing IPR is an essential component
to finishing with broad f lat contacts,
minimizing or eliminating distracting
black triangles. Class II elastics were
utilized to address the A/P discrepancy.
For space closure, we run elastic closing
chain 7-7 for one visit at most and always
under the wire.
Tr a n s v e r s e a r c h d e v e l o p m e n t
through the use of Damon light-force
mechanics a llows the expression of
anterior crowding into the space gained
in the posterior. Disarticulation, posterior
arch development, and controlling the
mechanics were the focus of this case.
Moreover, the rotational control built
into the DQ2 bracket and its refined
slot tolerances mean you can fi nish with
excellent control.
Results
This case resolved to a more than satisfactory finish in 18 months to a Class I occlusion.
The case is retained with a bonded retainer
L3-3 with removable U/L clear retainers.
The transverse development was key to
resolving her maxillary anterior crossbite and
severe crowding. Her balanced pretreatment
facial profile, which would have been marred
had extraction therapy been employed, was
beautifully maintained (Fig. 2).
Conclusion
The Q2 bracket has several key advantages that this case exemplifies. The most
important of these advantages is its means
for transverse development that allows such
crowded cases to be treated non-extraction
with no expansion devices. This bracket,
combined with Damon system mechanics,
created the critical space necessary to achieve
this beautiful full-tooth smile while negating
the adverse side effects of anterior flaring. ■
orthotown.com \\ JANUARY/FEBRUARY 2020
41
http://www.orthotown.com
Orthotown January/February 2020
Table of Contents for the Digital Edition of Orthotown January/February 2020
Orthotown January/February 2020 - Cover1
Orthotown January/February 2020 - Cover2
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